As COVID-19 vaccine clinical trials continue to advance and the vaccination nears its approval, its mass distribution will be the next global challenge.
As such, an efficient distribution channel for approved COVID-19 vaccines is needed. This will require proper storage of products, smooth cold chain transport, timely shipping, and reliable storage solutions.
Like many vaccines, the COVID-19 vaccine needs to be kept in a low yet precise temperature range from the moment it departs the manufacturer up to the time it’s administered to the patient.
A minor error in the process could lead to grave repercussions. Temperature management problems and inappropriate shipping procedures from even a single storage port could disrupt the cold chain system, and in effect, reduce the potency of the injections to the point of its ineffectiveness.
The World Health Organization states that over 50% of vaccines are wasted worldwide annually due to improper temperature control and shipment issues. Due to the scale of COVID-19, such a spoilage rate could potentially destroy a billion injections. Not only would managing these problems prevent an enormous financial loss but more importantly, it could possibly save millions of lives.
Main cold chain challenges
Since the distribution would be done globally, it is highly plausible that the vaccine may be mishandled at some point in the process. Some countries may be less equipped to handle the needed storage requirements as compared to others. The main challenges in the mass distribution of the COVID-19 vaccine are the temperature excursions and the lack of visibility in the cold chains.
Temperature excursions compromise drug quality and integrity. The biopharma industry loses an estimated amount of $35 billion yearly, according to the IQVIA Institute for Human Data Science due to temperature management failures in cold chains. Therefore, the need to secure reliable equipment to ensure proper temperature control in the supply chain for the COVID-19 vaccines is a priority.
Due to the time and temperature-sensitive quality of the vaccines, it is vital that the condition, location, and product subcomponents are properly disclosed based on real-time data. A highly detailed and precise data of the current status of the shipments and cargo is crucial to improving the process and avoiding congestions in the supply chain. Visibility is essential in a cold chain in order to take the necessary proactive measures to ensure that the quality of the vaccine is maintained all throughout the process.
Government authorities should take essential steps to ensure the effective delivery of the vaccine through the cold chain system.
Necessities for an optimum cold chain system
Planes, trucks, and cold storage warehouses are the major infrastructures involved in a cold chain. How they are interconnected varies on the origin where the vaccine is produced and the specific location it is needed.
The projected size of the delivery is huge. The International Air Transport Association (IATA) mentioned that to be able to provide a single dose to 7.8 billion people would require 8,000 747 cargo aircraft. It is also important to note that a single vaccine may require several doses. Necessary improvements and preparations are needed in order to avoid causing a massive strain in the cold chain.
Delivering billions of doses of vaccine to the entire world efficiently will involve hugely complex logistical and programmatic obstacles all the way along the supply chain. We look forward to working together with government, vaccine manufacturers and logistical partners to ensure an efficient global roll-out of a safe and affordable COVID-19 vaccine,
according to Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance.
Upon the production of vaccines, it will be transported in line with international regulatory policies to an airport with the necessary compatible low temperature air cargo capabilities. Due to the emergence of packing technologies, and visibility software tools, Track-and-trace technology can be integrated into Air Cargo container fleets to better monitor the shipment process. Supply chain visibility software also allows the possibility for immediate intervention and extensive tracking to occur in real-time. Once the air cargo has reached the country of its destination, the vaccines will be stored in storage facilities with the appropriate temperature conditions before they are distributed to health care facilities. Since keeping the vaccines at a controlled temperature is important in maintaining the integrity of the vaccines, the procurement of highly reliable and resilient refrigerator units is essential for the success of the cold chain.
Facilities and Preparations
A vaccine needs to be kept at a temperature of 2–8 °C (35.6–46.4 °F) throughout the shipping process to maintain its integrity. Improper temperature control on a single transport or storage system can disrupt the cold chain and render a shipment of vaccines obsolete.
Due to the global scale distribution required, cold chain facilities need to be prepared adequately to cater to the great demand. Countries should procure temperature-controlled facilities and specialized equipment by either repurposing existing infrastructures or initiating temporary builds to expand storage capacity. Some major logistics companies, like UPS and DHL, have started investing in the procurement of storage facilities and equipment for cold chain management. UPS is adding freezer farms composed of 600 freezers expected to hold 48,000 vials of vaccine.
Cold chain staff should also be trained and equipped with the necessary technical knowledge in handling time and temperature-sensitive vials. It is still uncertain which vaccine will be the first to be authorized for distribution, with many vaccines currently being developed by different pharmaceutical companies. Since different vaccines require various handling and temperature procedures, cold chain staff should be prepared and trained on how to handle each vaccine.
The foundation of an effective supply chain is visibility. Visibility paves the way for supply chain members to be aware of the current process taking place relevant to the distribution which would then help them to mobilize and act accordingly.
To ensure that the vaccine remains viable, it is important that companies have accurate and reliable tracking systems and sensors in place. Proactive monitoring capabilities should also be in place to ensure that the quality of the distributed vaccines is maintained. Given the gravity of the situation and the global impact of COVID-19, simply knowing where the vaccine is will not be enough to effectively distribute the vials worldwide. Fortunately, the existence of today’s innovative information and communication technologies allows for transparency and sustainability to take place in cold chains.
In such a wide-scale distribution, it is important to be able to detect and respond to the minimal changes and signals that occur during the process. This ability requires a powerful sensing system by using technologies such as cloud computing and Internet of Things (IoT) while further strengthening technologies like integrated systems, visual machine learning, and sensors. Such utilization of technologies can aid in monitoring the vulnerable points of the cold supply chain. While heat is indeed a great threat for the vaccine, freezing temperatures from faulty refrigerators and ice-cooled vaccine carriers pose a greater risk. These innovations can help identify certain old fridges that are damaging the vaccines. With advanced sensors that can transmit temperature information to the cloud, health workers can gather the data they need to prevent the occurrence of losses and streamline the current planning and execution systems in place. The gathered data can also help minimize errors in order to prevent vaccines from spoiling before they are delivered to the demand point.
Security and International Air Transport Guidelines
The COVID-19 vaccine is a highly sought commodity worldwide. Therefore, arrangements must be made in order to ensure that it will be protected from unwanted tampering and theft. Shipment cargo must remain secure throughout the process while considering the projected volume of the shipments to ensure that the delivery plan is sustainable, scalable, and feasible.
As part of COVID-19 prevention measures, many governments have established stringent measures to contain the disease from spreading, and while necessary, this step has also led to an increase in processing times. Since the vaccine will be transported across borders worldwide, it is also important to properly coordinate regulatory board approvals and customs clearance.
Another factor that could affect the transport of the vaccines is the diminished cargo capacity of the global air transport industry. Due to the severe decrease in passengers, many airlines have downsized operations and placed aircrafts into remote long-term storage. Though land transport might be useful in countries with developed economies with local manufacturing capacity, vaccines will not be delivered globally without using a sizable amount of air cargo.
Conclusion
The success of the mass distribution of the COVID-19 vaccine will depend upon proper projection and immunization size in proportion to the service delivery level. Since the development of the vaccine is underway, it is the primary task of cold chain transporters to prepare and plan a distribution strategy to ensure the on-time and efficient delivery of the vaccine worldwide. Billions of people globally need to receive plausibly two doses of vaccine. This mass vaccination requires a complex cold chain on a grand scale. Strengthening the cold chain for global distribution is the key to ending the pandemic immediately.
References:
https://www.unicef.org/press-releases/time-prepare-covid-19-vaccine-transport-now
https://fortune.com/2020/09/17/covid-vaccine-distribution-cold-chain
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